In my 6-month post ablation update I mainly talked about the rampant PVCs and PACs I was experiencing. I also mentioned that I was going to be wearing a holter monitor for 7 days.
Well I wore the monitor for 7 days and just as I expected, Dr. Natale didn’t find anything unusual or concerning going on. I was having PVCs and PACs but nothing abnormal. On my worst days during the seven days I was “only” having about 1,000 PVCs. I know that sounds like a lot of PVCs but apparently doctors don’t get worried about it until you start approaching 20,000 PVCs per day or you get a number of PVCs in a row.
Since I returned the monitor almost a month ago now, I have continued to suffer from PVCs and PACs. Sure I have good days but I’ve been having more bad days than good – and the bad days are awful. On those days, the constant PVCs and PACs are as bad as an afib episode. They suck!
PVCs, PACs – and Now Possibly Bradycardia?
Up until about 2013 my resting heart rate was around 42 beats per minute. I was a daily jogger for years so that’s why my heart rate was so low. Fortunately, I had zero issues with such a slow heart rate. My dad used to always give me shit about my heart rate. He’d say comments like, “With your heart rate you should be dead. I have no idea how you’re alive.” We always have a good laugh about it.
Then in 2013 I stopped exercising so vigorously and over time my heart rate increased to about 52 beats per minute. That was my new normal heart rate – right up until the day of my ablation.
Immediately following my ablation, and for almost five months after my ablation, my new resting heart rate was in the mid to upper 80s. Surprisingly, I didn’t feel any different and life was still good.
Around the fifth or sixth month after my ablation, my resting heart rate dropped to the mid 60s to the mid 70s. Here seven months after my ablation that is my current resting heart rate. I suspect it will continue to go down until it gets to my pre-ablation resting heart rate of 52 beats per minute.
While this gradual decline of my resting heart rate looks good on paper, there has been something going on that I’m a little concerned about.
I’ll be sitting down (or lying down) and I’ll take a random check of my pulse with my Apple watch and I’ll be in the mid 30s or mid 40s. It freaks me out when that happens because I always wonder if my heart is going to drop further or stop all together!
Now it’s possible that my Apple watch isn’t getting a solid reading for whatever reason (maybe because of the constant PVCs and PACs), but it will show a pulse in the mid 30s or mid 40s for a solid minute or two. Then suddenly it will switch to my usual mid 60s or mid 70s.
If this isn’t a glitch in my Apple watch, then I’m concerned that my heart rate is randomly dropping quite dramatically. I’ve obviously suffered from bradycardia for years and it’s never been an issue but even during my hardcore exercise days I never dropped under 40 beats per minute (that I knew of at least).
And this time around when I catch my heart rate so low I always have a slight headache or feel “off.” These are classic symptoms of bradycardia. So while bradycardia is nothing new to me, having symptoms from it is. I’m also not used to seeing my heart rate in the mid 30s!
I’m hoping these random readings are false and my Apple watch is just giving me the occasional incorrect reading but if its correct and I am suffering from bouts of bradycardia, then I may potentially be facing some other interesting developments in the future. Can we say pacemaker???
Next Steps: Dr. Natale Visit, Hormone Panel, & More Supplements
I am flying down to Austin, TX to visit with Dr. Natale on October 12th as a standard follow up visit from my ablation. He likes to see his patients in person for a follow up visit within a year of having an ablation so I figured now would be a good time. As you can imagine, I’ll have lots of questions for him!
I’m also having an echocardiogram (echo) when I’m down there as you normally have one done around the 6 month mark after an ablation. I’m hoping everything checks out. If they find anything abnormal – even if it’s something minor – I’m going to be super stressed out.
I’ll be posting an update after the echo and my appointment with Dr. Natale so be on the lookout for that.
I’ve also been looking into adrenal fatigue/adrenal inefficiency as I suspect that may be part of the cause of my rampant PVCs and PACs. To that end I had a phone appointment with a local naturopathic doctor the other day and he agreed that it would definitely be something worth looking into.
As a result, I’m going to have a hormone panel done to see if there is anything abnormal going on with my hormones, particularly cortisol (the notorious stress hormone). This panel consists of taking a few saliva samples throughout a given day and then sending in the test kit to be analyzed.
My naturopathic doctor also recommended I start taking hawthorne berry for the PVCs and PACs and ignatia for stress, grief, and general anxiety. I’ll be trying these in the coming days.
All this naturopathic stuff is a bit foreign to me and at times feels a little like witchcraft but I’m desperate and willing to explore anything at this point to feel normal again. If my hormones are out of whack and something can be done to restore them what can it hurt? And if homeopathic remedies such as hawthorne berry and ignatia can help, then I’d be a fool not to at least try them.
I also continue to experiment with what seems like every supplement under the sun. I’m sure my wife thinks I’m going crazy as it seems like every week a new supplement is delivered by the UPS guy. The latest supplements I’ve been trying out are a magnesium oil spray called EASE, hawthorne solid extract, and a couple different forms of magnesium (magnesium L- theonate and a time-release magnesium by Jigsaw).
I also continue to experiment with the amount of magnesium I’m taking (sometimes no magnesium and sometimes as much as 1,000mg a day) and the amount of potassium I’m taking (drinking anywhere from 1-3 glasses of low-sodium V-8 throughout the day).
I haven’t been able to find anything that works but to be fair my experiments have been all over the board. The constant changes in my supplements may be contributing to the very PVCs and PACs I’m trying to cure! Who knows. At times I think about just throwing all my supplements away to see what happens. Maybe that will be my next experiment…stay tuned.
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Hi Travis,
How many PVCs and PACs you where having during your bad days? (You have wrote about PVCs number only)
Currently I’m passing a bad period of many PACs and few PVCs; the wrost after my index ablaton.
Regards,
Christian
Christian:
I honestly don’t know as I never actually counted them. I can just tell you on my bad days it was (and is) awful. I still struggle with PVCs and PACs from time-to-time. It’s really weird because I’ll go a few days without anything and then I’ll have a few days where I have nonstop PVCs and/or PACs.
I will say they are getting better as time has passed but I’m well over a year past my first ablation and I still get them so these things can take a while to settle down! Hang in there!
Travis
Hi Travis,
I asked you about the number of PACs because you mentioned the number of PVCs in your post. So I thought that you had these number from your holter reports.
Currently I am having fewer PACs during day. But at night sometimes I am having many PACs per minute. This thing freaks me out.
Of course that comes to my mind the possibility of reconnection of the pulmonary veins.
It is very frustrating that I have had one year and three months of pratically zero PACs/day and now they came back to disturb my inner peace.
Regards,
Christian
Christian:
I totally understand the frustration. I share the same frustrations when my PVCs/PACs flare up. What gets me through those periods, however, is I just keep telling myself at least I’m not experiencing afib and I’m not forced to take any drugs to cure them!
Travis
Travis,
Eat an apple, and throw the watch away. Those things are terrible monitors of heart rate in the presence of anything but NSR. I’ve returned every HRM I’ve ever bought to the store.
No kidding, right? In one of my recent updates I talk about the Apple Watch and why it might have been giving me such odd readings. Here is a link to that post:
https://www.livingwithatrialfibrillation.com/1760/my-visit-with-dr-andrea-natale/
Be well.
Travis
Travis,
Wanted to say thank you for this blog. I had my first experience with what I think was AFIB last week and this blog has taught me a lot.
Quick run down of my experience.
Last Thursday morning I woke up around 2am feeling weird. My heart felt like it was flopping around in my chest. Got out of bed, splashed some water on my face and walked around a bit. It still wouldn’t stop so I woke my wife up and told her I think I need to go to ER.
At the ER my heart rate was around 140, the doc said he thought I was having SVT attack. He consulted a cardiologist and he agreed. At this point my heart rate was all over the place, one second I was down to the low 70s next I was 110. They gave me a beta blocker and that didn’t seem to help much, so they gave me another dose, and it did help some what but my heart rate was still up and down. Around this time there was a shift change in the ER and I got all new nurses and Doctor. This new doctor came in and said I was having AFIB but it looked better now. So they released me with instructions to take a beta blocker for 10 days and follow up with cardiologist. After getting home my heart rate was up and down a little but stablized a few hours later and I have been fine since.
So I am really confused what the hell happened to me, was this AFIB, SVT or both? I’m also freaked out that it will happen again. I have an appointment with the cardiologist next Friday so I hope to get some answers then.
Thanks!
Paul
Paul:
Hey Paul. With one doctor saying you were having SVT and another saying Afib, it’s impossible to know what was going on. It’s possible you were in both. There were times in the past when I would go to the ER they would classify me as SVT at first…but then on the official report it was afib.
After your appointment on Friday stop by here and leave an update. I’d love to hear what your cardiologist says.
Be well.
Travis
My primary care doc called me after the ER visit and wanted to see me right away. He scheduled me for an event monitor, and I got it a little over a week ago. It’s one of the new ones, no wires you just stick this pad to your chest and leave it on for 7 days.
I just got back from my follow up with him. Here is what they saw.
About 3 SVT events that last around 30 seconds and went back to normal. I felt all of those and hit the alert button on the montor.
1 AFIB event that I did not feel or at least I didn’t press the button. That last around 30 seconds as well.
Random PVCs events over the course of the seven days.
So now I am officially freaked out. I could deal with the SVT but the AFIB scares the crap out of me.
I have an appointment with the cardiologist tomorrow to go over the results with him so maybe he can tell me more. The Doc says my CHAD score is very low so if I go into AFIB my risk of stroke is low, but he wants me on aspirin.
I leave on vacation with my wife on Sunday for Hawaii, but I pretty worried about something happing when I am away.
The other bad news is I have to give up Beer, and I love beer. I’m an avaded homebrewer and love the hobby.
So I guess I have to come to terms with my life with AFIB
Paul
Wish I read sooner, my 3 month appt was at 1 that day. My wife and I ran three miles around Ladybird Lake that morning. You could have joined. ;)
Did the holter not pick up these drops?
Hey Ashley! I would have loved to have hooked up with you. Wasn’t the weather just awesome? I LOVE hot weather so I was in heaven as the temps hit 100 degrees that afternoon. It was great.
How did your check up go? Did they do an echo? If so, did they find anything or was everything good to go? I had a bit of a scare with my echo that I’ll be sharing in my next update. Everything is good but there were a couple things that showed up that freaked me out initially.
I hope all is well!
Travis
Yeah pretty boring appt. Echo was normal. I’ll watch for your post. Anxious to hear what they found.
We walked up and down South Congress that Sunday. Was pretty freaking hot for October lol.
Travis, I will take this latest report as good news for your condition tho the symptoms must be annoying to deal with. Witchcraft abounds in the natural world Im afraid, and Ive had to weed out the charlatans. I had my natural dentist refer me to one that my gut told me wasnt on the level. I checked her credentials, and sure enough, an online diploma and a very controversial procedure. Not to mention the cost was ridiculous. At any rate, I agree with you on the amount of supps we take, love to toss them all and just eat right and exercise to stay healthy! Adrenals were mentioned to me also as I was experiencing extreme fatigue daily. Thyroid was normal range, however the other levels were low and with 3 weeks of treatment, I feel 100% better. Im not sure if this will keep AF in check, but its another issue checked off at least.
James:
That’s awesome that you were able to be treated within a 3 week period. I hope to be 100% someday soon too!
Travis
Following! And glad you had a good report and cannot wait to read about it, also sometimes our minds can lead us down a path of negativity and we just need reassurance once in a while to validate things from a trusted and capable source.
Hi Travis, sorry to hear the last couple of months have been less than ideal. Hope your appointment with Dr. Natale gives you some answers!
Also, your note on adrenal fatigue peaked my interest. About a month before my first afib episode, I saw a functional Medicine NP because I just felt so “off.” I did a saliva test for adrenal fatigue and was told I have Stage 3 Adrenal Fatigue. I was given a bunch of supplements, including magnesium, but stopped everything once afib started because I was so freaked out. I’ll be curious to see what your results are. I have a feeling Adrenal Fatigue and Afib might be connected on some level. I also struggle with PVC’s and PAC’s.
Anne:
I had my appointment with Dr. Natale today and I’ve got great news…everything is perfectly fine. I’ll be posting a lengthy update soon as I have all sorts of things to share.
I’m not sure I believe there is a direct connection between adrenal fatigue and atrial fibrillation but who knows. Nobody really knows what causes afib. I personally think it’s mainly genetic or simply a part of life’s bad luck lottery. Like why does someone get Parkinson’s, cancer, or MS? All of these conditions are very complex and it just seems you are either prone to get them due to genetics or you just drew the wrong card in life:(
I personally don’t care what the cause is…I just want a damn cure:)
Travis
So glad to hear your appointment went well! And I’m sure you’re right. I keep looking for answers, but there really is no answer. Just the luck of the draw :)
Sorry to read about your ectopics…You should take your radial pulse to see if it matches the apple watch.
Joe:
The problem is it happens so fast that by the time I think about checking my radial pulse the Apple Watch switches to my normal heart rate. The one time it was in the mid 30s for about a minute I was so shocked that I didn’t even think to double check it. Moving forward, however, I’ll be mindful to check my pulse if I see those readings on my Apple Watch. I’m hoping it’s just a glitch with the watch.
Travis
I have read that if the Apple watch is not really tight that inaccurate readings are common.
In addition to that, I learned after my appointment with Dr. Natale that what’s probably happening is that the Apple Watch is catching my pulse at the beginning of a PAC. When PVCs and PACs occur there are slight pauses but the Apple Watch records everything so when it reads those pauses it thinks my pulse is in the 30s or 40s when it actually just picked up the beginning of a PAC. This explains why my Apple Watch quickly switches from the 30s to the 40s to my normal heart rate within a minute or less. I’ll be posting about this in an update soon.
Travis
sorry Travis .. will look forward to your report from Dr. Natales office
prayers
Charlene
Thanks Charlene!
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